RESUMO
OBJECTIVES: To assess the relation between plasma levels of prolactin and spontaneous movements in children anesthetized with propofol and to compare the prolactin endocrine response for 2 different techniques of anesthetic maintenance. PATIENTS AND METHOD: This was a prospective study of 35 ASA I children between 4 and 11 years of age, with no history of epilepsy or febrile convulsions, who underwent herniorrhaphy or orchidopexy. The patients were not premedicated. Before induction they received 0.02 mg/kg atropine and 2.5 micrograms/kg i.v.; induction was with 4 mg/kg propofol and 0.5 mg/kg atracurium. For maintenance the sample was randomly divided into 2 groups. Group A (n = 18) received 10 mg/kg/h propofol and 40% O2/air. Group B (n = 17) received 1-0.7% isoflurane and 40% N2O/O2. We measured plasma levels of prolactin before induction (baseline prolactin) and after extubation (postoperative prolactin). We also assessed pain upon injection of propofol by observing and recording spontaneous movement. RESULTS: The number of children who remained in the study was 24, with 14 in group A and 10 in group B. We observed a significant increase (p < 0.05) of postoperative prolactin in children with spontaneous movement (15.3 +/- 7.5 vs. 87.1 +/- 42.9 ng/ml) as well as in those with no movement (23.8 +/- 15.9 vs. 82.4 +/- 29.7 ng/ml). There were no significant differences between baseline prolactin (20.9 +/- 16.9 vs. 21.8 +/- 10.8 ng/ml) and postoperative levels (90 +/- 35.4 vs. 75 +/- 29 ng/ml) related to technique. CONCLUSIONS: Increase in prolactin is unrelated to spontaneous movements, which are attributable to low induction dose. Differences in prolactin plasma levels are not related to anesthetic technique.
